Surgical method and system for performing the same

Abstract

A system (10) including an helicoidal member (16); an elongated guide (26) positionable at least partially through the helicoidal member (16) along the longitudinal axis of helicoidal member (16), the guide (26) defining a longitudinally extending peripheral surface cooled portion (32); a cooling subsystem (33) for cooling the peripheral surface cooled portion (32); and a driver (34) for mounting the helicoidal member (16) thereto and rotating the helicoidal member (16) along the helicoidal member longitudinal axis while allowing the helicoidal member (16) to advance along the guide (26) in a distally oriented direction.

What is claimed is: 
     
       1. A system for performing a surgical procedure in a target biological tissue, the target biological tissue defining a target tissue exposed surface, the system comprising:
 a substantially helicoidal member, the helicoidal member defining an helicoidal member longitudinal axis and substantially longitudinally opposed helicoidal member proximal and distal ends; 
 a substantially elongated guide positionable so as to be extending at least partially through the helicoidal member along the helicoidal member longitudinal axis, the guide defining a guide tip and a guide peripheral surface extending substantially longitudinally from the guide tip, the guide peripheral surface having a peripheral surface cooled portion covering at least part of the guide peripheral surface; 
 a cooling subsystem operatively coupled to the guide for selectively cooling the peripheral surface cooled portion to a temperature sufficiently low to cause adhesion between the guide and the target biological tissue, the cooling subsystem including a coolant passageway having a portion thereof substantially adjacent to the peripheral surface cooled portion, the coolant passageway being configured for circulating a coolant therethrough to cool the peripheral surface cooled portion, the cooling subsystem further including a coolant source in a fluid communication relationship with the coolant passageway for providing coolant thereto; 
 a driver, the helicoidal member being mounted to the driver at the helicoidal member proximal end, the driver being operative for selectively simultaneously rotating the helicoidal member along the helicoidal member longitudinal axis and allowing the helicoidal member to advance along the guide in a distally oriented direction; 
 wherein, in operation, when the cooling subsystem cools the peripheral surface cooled portion and the latter is positioned to abut against the target tissue exposed surface, the peripheral surface cooled portion adheres to the target tissue exposed surface so that the driver can operated to drive the helicoidal member into the target biological tissue by rotating the helicoidal member and advancing the helicoidal member along the guide with the peripheral surface cooled portion remaining fixed relative to the target biological tissue. 
 
     
     
       2. The system as defined in  claim 1 , wherein the helicoidal member is selectively detachable from the driver. 
     
     
       3. The system as defined in  claim 1 , wherein the driver includes a driver lock movable between a locked configuration and an unlocked configuration, wherein, in the locked configuration, the helicoidal member is locked to the driver, and, in the unlocked configuration, the helicoidal member is detachable from the driver. 
     
     
       4. The system as defined in  claim 3 , wherein the driver includes a substantially helicoidal thread configured and sized for receiving part of the helicoidal member at the helicoidal member proximal end. 
     
     
       5. The system as defined in  claim 4 , wherein the helicoidal member is provided with at least one notch substantially longitudinally extending substantially adjacent the helicoidal member proximal end and the driver lock includes a pin insertable in the notch when the helicoidal member is operatively secured to the driver in the helicoidal thread, the pin being selectively removable from the notch, the pin being inserted in the notch in the locked configuration and the pin being removed from the notch in the unlocked configuration. 
     
     
       6. The system as defined in  claim 5 , wherein the lock includes a wire secured to the pin and the pin is mounted in a substantially longitudinally extending pin receiving passageway intersecting the helicoidal threads, the pin being removable from the pin receiving passageway by pulling on the wire. 
     
     
       7. The system as defined in  claim 1 , wherein the guide is hollow and the cooling subsystem includes a coolant tube positioned at least partially in the guide, the coolant tube defining at least part of the coolant passageway. 
     
     
       8. The system as defined in  claim 7 , wherein the guide is closed at guide tip and the coolant tube is provided with at least one coolant tube outlet located in the guide substantially adjacent the peripheral surface cooled portion, the coolant tube having at least a portion thereof that is spaced apart from the guide so that coolant can be circulated from the coolant tube, through the coolant outlet and between the coolant tube and the guide. 
     
     
       9. The system as defined  claim 1 , further comprising a substantially elongated catheter defining substantially opposed catheter proximal and distal ends and a catheter lumen extending therebetween, the guide being partially provided in the catheter lumen and protruding therefrom at the catheter distal end. 
     
     
       10. The system as defined in  claim 1 , further comprising a hook removably mountable to the helicoidal member and a suture thread secured to the hook. 
     
     
       11. The system as defined in  claim 10 , wherein the helicoidal member is made of a hollow tube, the suture thread extending through the hollow tube and the hook engaging the hollow tube at the helicoidal member distal end. 
     
     
       12. The system as defined in  claim 10 , wherein the driver is further operative for retracting the helicoidal member in a proximally oriented direction and the hook is removable from the helicoidal member when the hook is pulled. 
     
     
       13. The system as defined in  claim 1 , wherein the peripheral surface cooled portion is at least partially substantially flat. 
     
     
       14. The system as defined in  claim 1 , further comprising an insert mounted to the guide, the insert and guide being longitudinally movable relative to each other. 
     
     
       15. The system as defined in  claim 14 , wherein the insert includes a substantially tubular membrane positioned over the guide peripheral surface, the membrane being provided with apertures in register with the peripheral surface cooled portion. 
     
     
       16. The system as defined in  claim 14 , wherein the insert includes a membrane positioned over the guide peripheral surface opposed to the peripheral surface cooled portion so that the peripheral surface cooled portion is free of the membrane. 
     
     
       17. The system as defined in  claim 16 , further comprising attachment loops securing the membrane to the guide, the attachment loops extending circumferentially around the guide. 
     
     
       18. The system as defined in  claim 16 , wherein the guide defines a pair of substantially longitudinally extending mounting grooves and the insert defines a pair of substantially longitudinally extending mounting rods each mounted in a respective one of the mounting grooves. 
     
     
       19. The system as defined in  claim 14 , wherein the helicoidal member is inserted through the insert. 
     
     
       20. The system as defined in  claim 1 , wherein the helicoidal member has the same shape before and after insertion in the target biological tissue. 
     
     
       21. The system as defined in  claim 1 , wherein the helicoidal member includes a shape memory material, the helicoidal member changing between an helicoidal member first configuration and an helicoidal member second configuration at a transition temperature, the transition temperature being between 20° C. and 37° C. 
     
     
       22. The system as defined in  claim 21 , wherein the helicoidal member first and second configurations have different pitches. 
     
     
       23. A system for performing a surgical procedure in a target biological tissue using an helicoidal member, the helicoidal member defining an helicoidal member longitudinal axis and substantially longitudinally opposed helicoidal member proximal and distal ends, the target biological tissue defining a target tissue exposed surface, the system comprising:
 a substantially elongated guide positionable so as to be extending at least partially through the helicoidal member along the helicoidal member longitudinal axis, the guide defining a guide tip and a guide peripheral surface extending substantially longitudinally from the guide tip, the guide peripheral surface having a peripheral surface cooled portion; 
 a cooling subsystem operatively coupled to the guide for selectively cooling the peripheral surface cooled portion to a temperature sufficiently low to cause adhesion between the guide and the target biological tissue, the cooling subsystem including a coolant passageway having a portion thereof substantially adjacent to the peripheral surface cooled portion, the coolant passageway being configured for circulating a coolant therethrough to cool the peripheral surface cooled portion, the cooling subsystem further including a coolant source in a fluid communication relationship with the coolant passageway for providing cooled coolant thereto; 
 a driver, the helicoidal member being mountable to the driver at the helicoidal member proximal end, the driver being operative for selectively simultaneously rotating the helicoidal member along the helicoidal member longitudinal axis and advancing the helicoidal member along the guide in a distally oriented direction; 
 wherein, in operation, when the cooling subsystem cools the peripheral surface cooled portion and the latter is positioned to abut against the target tissue exposed surface, the peripheral surface cooled portion adheres to the target tissue exposed surface so that the driver can operated to advance the helicoidal member along the guide while driving the helicoidal member into the target biological tissue with the peripheral surface cooled portion remaining fixed relative to the target biological tissue. 
 
     
     
       24. A system for performing a surgical procedure in a target biological tissue, the target biological tissue defining a target tissue exposed surface, the system comprising:
 a substantially helicoidal member, the helicoidal member defining an helicoidal member longitudinal axis and substantially longitudinally opposed helicoidal member proximal and distal ends; 
 a substantially elongated guide positionable so as to be extending at least partially through the helicoidal member along the helicoidal member longitudinal axis, the guide defining a guide tip and a guide peripheral surface extending substantially longitudinally from the guide tip, the guide peripheral surface having a peripheral surface cooled portion covering at least part of the guide peripheral surface; 
 a cooling subsystem operatively coupled to the guide for selectively cooling the peripheral surface cooled portion to a temperature sufficiently low to cause adhesion between the guide and the target biological tissue; 
 a driver, the helicoidal member being mounted to the driver at the helicoidal member proximal end, the driver being operative for selectively simultaneously rotating the helicoidal member along the helicoidal member longitudinal axis and allowing the helicoidal member to advance along the guide in a distally oriented direction; 
 wherein, in operation, when the cooling subsystem cools the peripheral surface cooled portion and the latter is positioned to abut against the target tissue exposed surface, the peripheral surface cooled portion adheres to the target tissue exposed surface so that the driver can operated to drive the helicoidal member into the target biological tissue by rotating the helicoidal member and advancing the helicoidal member along the guide with the peripheral surface cooled portion remaining fixed relative to the target biological tissue; 
 wherein the driver includes a driver lock movable between a locked configuration and an unlocked configuration, wherein, in the locked configuration, the helicoidal member is locked to the driver, and, in the unlocked configuration, the helicoidal member is detachable from the driver; 
 wherein the driver includes a substantially helicoidal thread configured and sized for receiving part of the helicoidal member at the helicoidal member proximal end; and 
 wherein the helicoidal member is provided with at least one notch substantially longitudinally extending substantially adjacent the helicoidal member proximal end and the driver lock includes a pin insertable in the notch when the helicoidal member is operatively secured to the driver in the helicoidal thread, the pin being selectively removable from the notch, the pin being inserted in the notch in the locked configuration and the pin being removed from the notch in the unlocked configuration. 
 
     
     
       25. A system for performing a surgical procedure in a target biological tissue, the target biological tissue defining a target tissue exposed surface, the system comprising:
 a substantially helicoidal member, the helicoidal member defining an helicoidal member longitudinal axis and substantially longitudinally opposed helicoidal member proximal and distal ends; 
 a substantially elongated guide positionable so as to be extending at least partially through the helicoidal member along the helicoidal member longitudinal axis, the guide defining a guide tip and a guide peripheral surface extending substantially longitudinally from the guide tip, the guide peripheral surface having a peripheral surface cooled portion covering at least part of the guide peripheral surface; 
 a cooling subsystem operatively coupled to the guide for selectively cooling the peripheral surface cooled portion to a temperature sufficiently low to cause adhesion between the guide and the target biological tissue; 
 a driver, the helicoidal member being mounted to the driver at the helicoidal member proximal end, the driver being operative for selectively simultaneously rotating the helicoidal member along the helicoidal member longitudinal axis and allowing the helicoidal member to advance along the guide in a distally oriented direction; 
 wherein, in operation, when the cooling subsystem cools the peripheral surface cooled portion and the latter is positioned to abut against the target tissue exposed surface, the peripheral surface cooled portion adheres to the target tissue exposed surface so that the driver can operated to drive the helicoidal member into the target biological tissue by rotating the helicoidal member and advancing the helicoidal member along the guide with the peripheral surface cooled portion remaining fixed relative to the target biological tissue; 
 wherein the helicoidal member has a pitch that varies between the helicoidal member proximal and distal ends. 
 
     
     
       26. The system as defined in  claim 25 , wherein the pitch is larger at the helicoidal member distal end than at the helicoidal member proximal end. 
     
     
       27. A system for performing a surgical procedure in a target biological tissue, the target biological tissue defining a target tissue exposed surface, the system comprising:
 a substantially helicoidal member, the helicoidal member defining an helicoidal member longitudinal axis and substantially longitudinally opposed helicoidal member proximal and distal ends; 
 a substantially elongated guide positionable so as to be extending at least partially through the helicoidal member along the helicoidal member longitudinal axis, the guide defining a guide tip and a guide peripheral surface extending substantially longitudinally from the guide tip, the guide peripheral surface having a peripheral surface cooled portion covering at least part of the guide peripheral surface; 
 a cooling subsystem operatively coupled to the guide for selectively cooling the peripheral surface cooled portion to a temperature sufficiently low to cause adhesion between the guide and the target biological tissue; 
 a driver, the helicoidal member being mounted to the driver at the helicoidal member proximal end, the driver being operative for selectively simultaneously rotating the helicoidal member along the helicoidal member longitudinal axis and allowing the helicoidal member to advance along the guide in a distally oriented direction; 
 wherein the peripheral surface cooled portion is at least partially substantially flat; and 
 wherein, in operation, when the cooling subsystem cools the peripheral surface cooled portion and the latter is positioned to abut against the target tissue exposed surface, the peripheral surface cooled portion adheres to the target tissue exposed surface so that the driver can operated to drive the helicoidal member into the target biological tissue by rotating the helicoidal member and advancing the helicoidal member along the guide with the peripheral surface cooled portion remaining fixed relative to the target biological tissue. 
 
     
     
       28. A system for performing a surgical procedure in a target biological tissue, the target biological tissue defining a target tissue exposed surface, the system comprising:
 a substantially helicoidal member, the helicoidal member defining an helicoidal member longitudinal axis and substantially longitudinally opposed helicoidal member proximal and distal ends; 
 a substantially elongated guide positionable so as to be extending at least partially through the helicoidal member along the helicoidal member longitudinal axis, the guide defining a guide tip and a guide peripheral surface extending substantially longitudinally from the guide tip, the guide peripheral surface having a peripheral surface cooled portion covering at least part of the guide peripheral surface; 
 a cooling subsystem operatively coupled to the guide for selectively cooling the peripheral surface cooled portion to a temperature sufficiently low to cause adhesion between the guide and the target biological tissue; 
 a driver, the helicoidal member being mounted to the driver at the helicoidal member proximal end, the driver being operative for selectively simultaneously rotating the helicoidal member along the helicoidal member longitudinal axis and allowing the helicoidal member to advance along the guide in a distally oriented direction; and 
 an insert mounted to the guide, the insert and guide being longitudinally movable relative to each other; 
 wherein, in operation, when the cooling subsystem cools the peripheral surface cooled portion and the latter is positioned to abut against the target tissue exposed surface, the peripheral surface cooled portion adheres to the target tissue exposed surface so that the driver can operated to drive the helicoidal member into the target biological tissue by rotating the helicoidal member and advancing the helicoidal member along the guide with the peripheral surface cooled portion remaining fixed relative to the target biological tissue. 
 
     
     
       29. The system as defined in  claim 28 , wherein the insert includes a substantially resiliently deformable piece of material provided opposed to the peripheral surface cooled portion. 
     
     
       30. The system as defined in  claim 29 , wherein the insert is made of a foam or polymeric material.